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Cui C, Chen Z, Luo L, Zeng J, Sun X, Sui L, Xu C, Fu Z, Cong Q. Value of loop electrosurgical excision procedure conization and imaging for the diagnosis of papillary squamous cell carcinoma of the cervix. Front Oncol 2023; 13:1166818. [PMID: 37476381 PMCID: PMC10354288 DOI: 10.3389/fonc.2023.1166818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Background Loop electrosurgical excision procedure (LEEP) conization and hysterectomy are performed for some patients with papillary squamous cell carcinoma (PSCC), whereas only hysterectomy is performed for others. We aimed to determine the optimal management for PSCC. Methods Patients diagnosed with PSCC by colposcopy-directed biopsy between June 2008 and January 2020 who underwent LEEP conization and hysterectomy or only hysterectomy at our hospital were enrolled. Results of cervical cytology, high-risk human papillomavirus testing, transvaginal sonography, pelvic magnetic resonance imaging, LEEP, hysterectomy, and pathology testing of colposcopy-directed biopsy samples were analyzed. Results A total of 379 women were diagnosed with PSCC by colposcopy-directed biopsy; 174 underwent LEEP before hysterectomy and 205 underwent only hysterectomy. Patients underwent and did not undergo LEEP were aged 47 ± 11 years and 52 ± 11 years, respectively. Among women who underwent LEEP, the agreement between LEEP and hysterectomy pathology was 85.1%. For women who underwent only hysterectomy, the agreement between preoperative clinical staging and pathological staging after hysterectomy was 82.4%. For patients with preoperative imaging indicative of malignancy, the accuracy of LEEP for diagnosing and staging PSCC was 88.5%, whereas for the hysterectomy-only group, it was 86.2%. For patients without malignancy detected with imaging, the accuracy of LEEP for diagnosing and staging PSCC was 81.6%; however, for those who did not undergo LEEP, it was 70.0%. Conclusion For women diagnosed with PSCC by colposcopy-directed biopsy, LEEP conization is necessary for an accurate diagnosis when imaging does not indicate cancer; however, LEEP is not necessary when imaging indicates cancer.
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Affiliation(s)
- Can Cui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ziren Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Lingxiao Luo
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jianping Zeng
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaoyi Sun
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Long Sui
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Congjian Xu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Zhongpeng Fu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
| | - Qing Cong
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, China
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Arab M, Pirastehfar Z, Afshar Moghaddam N, Raoufi M. Papillary squamotransitional cell carcinoma of the uterine cervix: A rare case report. Clin Case Rep 2023; 11:e7508. [PMID: 37305882 PMCID: PMC10256865 DOI: 10.1002/ccr3.7508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 05/11/2023] [Accepted: 05/28/2023] [Indexed: 06/13/2023] Open
Abstract
Key Clinical Message Although papillary squamotransitional cell carcinoma is an uncommon variant of cervical squamous cell carcinoma, due to the complex papillary structure and the challenge in detecting stromal invasion, its timely diagnosis and treatment are very important. Abstract Papillary squamotransitional cell carcinoma (PSTCC) is extremely rare and presents with a spectrum of morphologies. PSTCC may present as an in situ tumor with or without an invasion, but usually, it displays both features. Here we report a 60-year-old woman, diagnosed with PSTCC of the uterine cervix.
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Affiliation(s)
- Maliheh Arab
- Department of Gyneco‐oncology, Imam Hossein Medical CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Zanbagh Pirastehfar
- Department of Obstetrics and Gynecology, School of Medicine, Imam Khomeini HospitalMazandaran University of Medical SciencesSariIran
| | - Noushin Afshar Moghaddam
- Department of Pathology, School of Medicine, Imam Hossein Medical CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Masoomeh Raoufi
- Department of Radiology, School of Medicine, Imam Hossein Medical CenterShahid Beheshti University of Medical SciencesTehranIran
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Papillary Squamotransitional Cell Carcinoma of the Uterine Cervix with Atypical Presentation: A Case Report with a Literature Review. Medicina (B Aires) 2022; 58:medicina58121838. [PMID: 36557040 PMCID: PMC9785399 DOI: 10.3390/medicina58121838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction: Cervical cancer is the fourth most prevalent malignancy and the fourth leading cause of cancer-related death in women around the world. Histologically, squamous cell carcinoma (SCC) is the most common form of cervical cancer. SCC has several subtypes, and one of the rarest is papillary squamotransitional cell carcinoma (PSCC). In general, PSCC is believed to have a similar course and prognosis to typical SCC, with a high risk of late metastasis and recurrence. Case report: We discuss the case of a 45-year-old patient diagnosed with PSCC who was admitted to our department in December 2021. The clinical manifestations were pelvic discomfort and lymphadenopathy throughout the body. On admission, all laboratory values, with the exception of C-Reactive Protein (CRP) at 22.35 mg/L and hemoglobin (HGB) at 87.0 g/L, were normal. The clinical and ultrasound examination revealed a painful formation with indistinct borders in the right portion of the small pelvis. Following dilation and curettage, a Tru-Cut biopsy of the inguinal lymph nodes was performed. The investigation histologically indicated PSCC. MRI of the small pelvis showed an endophytic tumor in the cervix with dimensions of 35/26 mm and provided data for bilateral parametrial infiltration; a hetero-intensive tumor originating from the right ovary and involving small intestinal loops measuring 90/58 mm; and generalized lymphadenopathy and peritoneal metastases in the pouch of Douglass. The FIGO classification for the tumor was IVB. The patient was subsequently referred for chemotherapy by the tumor board's decision. Discussion: Despite the generally good prognosis of SCC, PSCC is a rare and aggressive subtype. It is usually diagnosed at an advanced stage and has a poor prognosis. Conclusions: PSCC is a rare subtype of SCC, and its diagnosis and treatment are challenging.
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Woo HY, Kim HS. Local and Metastatic Relapses in a Young Woman with Papillary Squamous Cell Carcinoma of the Uterine Cervix. Diagnostics (Basel) 2022; 12:diagnostics12030599. [PMID: 35328152 PMCID: PMC8946994 DOI: 10.3390/diagnostics12030599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/07/2022] [Accepted: 02/21/2022] [Indexed: 02/07/2023] Open
Abstract
Papillary squamous cell carcinoma (PSCC) is a rare histological type of cervical carcinoma whose biological behavior has not been fully established. A 33-year-old woman with an exophytic cervical mass underwent radical hysterectomy and bilateral pelvic lymph node dissection. Histological examination of the tumor revealed numerous papillary fronds lined by atypical stratified squamous cells, resembling high-grade squamous intraepithelial lesions or urothelium. She was diagnosed with stage IB1 PSCC. Three months postoperatively, a 5.7 cm vaginal stump mass was detected. She received chemoradiotherapy, which helped her achieve a complete response. However, nine months postoperatively, she developed pelvic lymph node metastases. We present a rare case of recurrent cervical PSCC in a young woman. PSCC of the uterine cervix can recur rapidly within just a few months and become aggressive, as in the present case.
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Affiliation(s)
- Ha Young Woo
- Department of Pathology, National Cancer Center, Goyang 10408, Korea;
- Department of Pathology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul 02447, Korea
| | - Hyun-Soo Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Correspondence:
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Sone K, Inoue F, Taguchi A, Hinata M, Ikemura M, Miyamoto Y, Michihiro T, Ohno T, Iriyama T, Mori-Uchino M, Tsuruga T, Mishima M, Osuga Y. A case of difficult-to-diagnose non-invasive papillary squamous cell carcinoma of the uterine cervix infected with human papilloma virus 6: A diagnostic pitfall. Clin Case Rep 2021; 9:e04905. [PMID: 34631088 PMCID: PMC8489388 DOI: 10.1002/ccr3.4905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 02/06/2023] Open
Abstract
We encountered HPV6-positive cervical papillary squamous cancer (PSCC) that was difficult to diagnose. The case was initially diagnosed and treated for condyloma. To the best of our knowledge, this is the first report of HPV6 infection in PSCC.
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Affiliation(s)
- Kenbun Sone
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Futaba Inoue
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Ayumi Taguchi
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Munetoshi Hinata
- Department of pathology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Masako Ikemura
- Department of pathology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yuichiro Miyamoto
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Tanikawa Michihiro
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | | | - Takayuki Iriyama
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Mayuyo Mori-Uchino
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Tetsushi Tsuruga
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Misako Mishima
- Department of pathology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
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Zhang W, Gao Y, Zhang W, Lin Z, Bi H, Zhu L. Survival outcomes and prognostic factors of papillary serous adenocarcinoma and papillary squamous cell carcinoma of the uterine cervix. J OBSTET GYNAECOL 2021; 42:1233-1238. [PMID: 34565276 DOI: 10.1080/01443615.2021.1945559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this retrospective population-based study was to investigate the survival outcomes and prognostic factors of patients with the two cervical carcinomas. A cohort of patients diagnosed with papillary serous adenocarcinoma of the uterine cervix (PSAC) and papillary squamous cell carcinoma (PSCC) between 1973 and 2015 were drawn from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database. Overall survival (OS) and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method, and prognostic factors were assessed using Cox proportional hazards survival regression analysis. The 5-year and 10-year OS rates were 38.4 and 33.1% for PSAC and 64.6 and 50.8% for PSCC, respectively. The 2-year and 5-year CSS rates were 60.6 and 45.9% for PSAC and 79.6 and 69.0% for PSCC, respectively. Patients with PSCC survive longer than PSAC patients and have other well-described prognostic factors for improved survival rates, including an early cancer stage, a younger patient age and standardised surgery.Impact statementWhat is already known on this subject? Papillary serous adenocarcinoma of the uterine cervix (PSAC) and papillary squamous cell carcinoma (PSCC)are both very rare subtypes of cervical carcinomas.What do the results of this study add? This retrospective population-based analysis has evaluated the survival outcomes and prognostic indicators of patients with PSAC and PSCC.What the implications are of these findings for clinical practice and/or further research? Knowing the survival outcomes and prognostic indicators of PSAC and PSCC patients, we can better follow up patients.
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Affiliation(s)
- Wei Zhang
- Department of Gynecology, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, P. R. China
| | - YuTao Gao
- Department of Gynecology, Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, P. R. China
| | - WenQue Zhang
- Department of Gynecology, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, P. R. China
| | - ZhiHong Lin
- Department of Gynecology, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, P. R. China
| | - HaiYan Bi
- Department of Gynecology, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, P. R. China
| | - LiBo Zhu
- Department of Gastroenterology, The People's Hospital of Yuxi City, The 6th Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, P. R. China
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Papillary Squamous Cell Carcinoma of the Uterine Cervix: Biopsy Samples Frequently Underrepresent the Presence of Stromal Invasion. Int J Gynecol Pathol 2020; 40:408-412. [PMID: 33323853 DOI: 10.1097/pgp.0000000000000728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma, histologically characterized by thin or broad papillae lined by epithelium showing the features of high-grade squamous intraepithelial lesion. Given the exophytic nature of these neoplasms, the diagnosis, assessment and quantification of invasion may be difficult in small biopsies. The goal of this study was to determine the presence and extent of cervical stromal invasion by comparing biopsy samples with excisional specimens in a cohort of patients diagnosed with papillary squamous cell carcinoma. Cases were identified from the surgical pathology files between the years 2003 and 2018 and only cases in which the patients underwent an excisional procedure following the diagnostic biopsy were included. Eighteen cases were identified. Patients age ranged 21 to 72 yr (mean: 46.2 yr). Review of the initial, presurgical biopsies showed that 17/18 (94%) patients had no evidence of stromal invasion. In the surgical excision specimens (2 cone biopsies, 1 loop electrosurgical excision procedure, and 15 hysterectomies), 13 cases (76.5%) showed invasive squamous cell carcinoma. Tumor sizes ranged 1.0 to 6.1 cm; stromal invasion ranged in depth 0.2 to 2.2 cm (median: 1.2), and in horizontal length 0.3 to 4.0 cm (median: 2.01). Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma of the cervix that may impose some diagnostic difficulties in small biopsies. Our findings demonstrated that the significant majority of cases might only show the presence of invasive cancer in excisional samples. Awareness of this data is important to guide proper management and avoid under-treatment.
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9
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Zhang X, Ding J, Tao X, Qian H, Hua K. Diagnosis and treatment of cervical papillary squamous cell carcinoma with unknown depth of stromal invasion. Int J Gynaecol Obstet 2017; 138:190-193. [PMID: 28504849 DOI: 10.1002/ijgo.12215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/18/2017] [Accepted: 05/12/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Xuyin Zhang
- Department of Gynecology; Obstetrics and Gynecology Hospital of Fudan University; Shanghai China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases; Shanghai China
| | - Jingxin Ding
- Department of Gynecology; Obstetrics and Gynecology Hospital of Fudan University; Shanghai China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases; Shanghai China
| | - Xiang Tao
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases; Shanghai China
- Department of Pathology; Obstetrics and Gynecology Hospital of Fudan University; Shanghai China
| | - Huijun Qian
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases; Shanghai China
- Department of Radiology; Obstetrics and Gynecology Hospital of Fudan University; Shanghai China
| | - Keqin Hua
- Department of Gynecology; Obstetrics and Gynecology Hospital of Fudan University; Shanghai China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases; Shanghai China
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Turker LB, Gressel GM, Abadi M, Frimer M. Papillary squamous cell carcinoma of the cervix: Two cases and a review of the literature. Gynecol Oncol Rep 2016; 18:18-21. [PMID: 27790636 PMCID: PMC5072143 DOI: 10.1016/j.gore.2016.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 11/28/2022] Open
Abstract
Objective Papillary squamous cell carcinoma of the cervix (PSCC) is a rare and distinct form of cervical carcinoma. Detecting stromal invasion on biopsy is difficult due to the papillary growth of the tumor. Here we present two cases that highlight the diagnostic and clinical challenges of PSCC. Case 1 A 50-year-old woman found to have carcinoma on a routine pap-smear. The patient was diagnosed with PSCC on colposcopic biopsy and underwent a radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. Her final pathology demonstrated PSCC with no evidence of stromal invasion. At her 3-month follow up visit, she was noted to have a tumor recurrence at the vaginal cuff, again with no stromal invasion. She is currently undergoing definitive radiation therapy with sensitizing cisplatin. Case 2 An 82-year-old woman presented with post-menopausal bleeding and was found to have an exophytic mass. Biopsies were taken and showed PSCC with no stromal invasion identified. She underwent a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Final pathology indicated no invasion. She is currently being followed for persistent vaginal dysplasia. Conclusion PSCC is a rare tumor that has previously been described as less aggressive than classical squamous cell carcinoma. These two cases demonstrate the complex behavior of the disease. Case 1 highlights that PSCC may recur even when stromal invasion cannot be confirmed pathologically. Describes two distinct cases of papillary squamous cell carcinoma (PSCC). The lack of stromal invasion continues to define aggressive tumor behavior. A multi-disciplinary approach is necessary in the treatment of patients with PSCC.
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Affiliation(s)
- Lauren B Turker
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Jacobi Medical Center, United States; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, United States
| | - Gregory M Gressel
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Jacobi Medical Center, United States; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, United States
| | - Maria Abadi
- Department of Pathology, Albert Einstein College of Medicine, Jacobi Medical Center, United States
| | - Marina Frimer
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Jacobi Medical Center, United States; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, United States
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